Posted Wednesday, Oct. 3, 2012
It’s up to recovering people to put addiction and treatment issues on the national agenda.
By Steve Diogo
In a recent RenewEveryDay.com survey, 80 percent of respondents said addiction and recovery issues are of key importance in the upcoming presidential election; yet half of these respondents say they have no idea where either candidate stands on these issues.
We would take that further. We would guess that many recovering people don’t know what the issues are—partly because recovering people don’t tend to be the most vocal, visible or politically active community, but also because there is gaping hole in the national conversation where substance abuse and recovery dialogue should be.
That needs to change. The first step is to identify the issues and push candidates and elected officials to address them. Despite numbers that place substance abuse at the top of America’s public health, social and criminal justice crises, neither candidate has taken a recognizable stand on substance abuse prevention and education, access to treatment, or the myriad healthcare, legal, social and workplace protection issues that impact recovering people. With the elections a month away, it’s time to take a look at the issues that impact the recovery community and take action to shatter the stigma of addiction, protect the rights of recovering people and ensure access to quality addiction treatment for everyone who needs it.
But don’t look to the candidates to define the debate. Both President Obama and Republican challenger Mitt Romney have remained all but silent on addiction and treatment, leaving the issues out of their platforms and sidestepping questions when they are posed in interviews and public forums.
MittRomney.com lists 25 issues—from Afghanistan to Veterans—you can explore vis-a-vis the candidate’s position. Substance abuse is not one of them. There is nothing about the issue in the section on Healthcare; nothing in Courts and Constitution. Nothing even in Values.
When pushed in public forums or interviews, Romney has voiced vague support for the typical tenets of the War on Drugs: Crack down on suppliers abroad while cutting demand for drugs in the U.S. Speaking in New Hampshire in August, Romney said he supports the war on drugs but put the onus on parents to teach children to avoid a “substance abuse lifestyle.”
“We've got to not only continue our war on drugs from a police standpoint but also to market again to our young people about the perils of drugs,” Romney said, according to an article in the Concord (N.H.) Monitor.
Like much of Romney’s philosophy, substance abuse prevention appears to come down to a question of business logic: Tell your kids that if they do drugs they won’t get a good job.
With Obama, we have the benefit of a policy record to consider, but even there, it can be difficult to determine where substance abuse and recovery fall on the list of priorities. In the past four years, the Obama Administration has increased funding to the Substance Abuse and Mental Health Services Administration (SAMHSA), signed the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act and implemented health care reform that promises expanded access to health care coverage for low-income individuals. An article in the July GQ reported that “administration sources” said Obama was considering drawing down the War on Drugs in a second term with a focus on reducing barriers to reentering society for recovering people—such as overturning policy that denies federal financial aid to college students convicted of possession. The White House later denied this, and Obama has remained distinctly silent on addiction and treatment issues in public forums and interviews. In an online “Ask Me Anything” chat on Reddit.com in August, for example, the president sidestepped drug-related questions. (Granted, these questions mostly were about legalizing marijuana.)
Obama’s choice for director of the Office of National Drug Control Policy (ONDCP), Gil Kerlikowske, has proven to be a moderate voice in the otherwise polarizing drug war, calling for evidence-based approaches aimed at reducing drug use and its consequences and reducing the historic emphasis on jailing offenders. As stated on the office’s website: “Specifically, the new Strategy is guided by three facts: addiction is a disease that can be treated; people with substance use disorders can recover; and innovative new criminal justice reforms can stop the revolving door of drug use, crime, incarceration, and re-arrest.”
At the same time, Obama downgraded Kerlikowske’s position from Cabinet level; and the Parity Act, which is intended to offer expanded insurance coverage for mental health issues, lacks the teeth it needs to meet its objective.
In a recent interview with Renew, Gen. Barry McCaffrey, Drug Czar under President Clinton from 1996 to 2001, criticized the Administration’s efforts.
“There’s some sense that parity is done, that we can declare victory,” McCaffrey said. “That’s not the case. The final language has not been completed. It has not been fully implemented. There are questions about enforcement. We continue to be in a perilous situation in terms of ensuring that people will have access to treatment at all levels.”
McCaffery also criticized what he called a lack of emphasis on prevention and education that is driving up adolescent drug use after 14 years of decline.
“I think we’ve backed off the prevention and education strategy,” McCaffrey said. “The last administration did. This administration has. It’s a mystery to me. We have eliminated a lot of the funding we had put together for a public communication strategy. We’re going to rue the day we did this.”
Time to take a stand
Substance abuse is America’s No. 1 public health, social and criminal justice crisis. More people will die this year because of substance abuse than will die from cancer, automobile accidents or terrorism. Yet, if addiction and recovery received a fraction of the funding and attention given these problems, we would consider it a major victory.
In his upcoming book, Recover to Live, Christopher Kennedy Lawford points out the following numbers, which highlight the discrepancy between substance abuse’s impact and the funding it receives. Cancer costs $96 billion a year in healthcare spending and receives $338 million a year in National Institutes of Health (NIH) research funding. Alcoholism costs $185 billion a year and receives $35 million in NIH research funding. Drug abuse costs $110 billion and receives $63 million. Something is wrong here.
“The American Cancer Society raises over a billion dollars a year to fight cancer,” Lawford said in an interview with Renew for a profile that will run in the November/December issue. “Cancer costs our nation one third of what addiction costs, but you know how much we raise? Twenty million. That’s all you need to know. You asked what we need to do? We need to get visible. We need to write checks. We need to create a recovery community. We need to develop a recovery economy.”
Across America, every day, people are dying from substance abuse because of lack of education, prevention and access to treatment. Tens of millions of Americans struggle with addiction, and those addicts can devastate the lives of tens of millions more. Indirectly, every American is affected by this crisis through spiraling health-care and criminal-justice costs, lost productivity and other costs. According to the National Institute on Drug Abuse (NIDA), substance abuse costs the United States $484 billion a year when you measure in healthcare costs, lost productivity, crime and accidents. Illicit drugs contribute to at least half of all violent crime.
This affects everyone. But recovering people have more at stake. Of critical importance are the insurance coverage issues addressed in the Obama Administration’s Affordable Care Act and putting teeth behind the Parity Act. This law—aimed at requiring health care plans to ensure equity in their coverage of mental health and physical health benefits—was passed in 2009 but is foundering under its lack of enforcement provisions.
Addiction is a disease and requires politically sober, evidence-based policy that treats it as the healthcare issue it is. Recovering people have too much at stake in this debate to allow it to be directed by rabid law enforcement on one side and the “Legalize it” crowd on the other. Determining the direction of drug policy and funding away from the failed war on drugs and toward prevention, education and expanded treatment; reinstating the ONDCP to Cabinet level status; pressuring state and local legislatures to fund drug prevention efforts, drug courts and other evidence-based interventions that have proven to be more successful than prison for addicts—these are issues core to the success of all recovering people. There are legal issues, employment issues, and discrimination issues—realities that impact the ability of recovering people to reenter society after treatment. These are issues that should be paramount to any recovering addict. They are why we need to vote and why we need to get active and get loud in the communities in which we live.
“We have to get visible,” says Lawford. “We have a recovery community in this country that’s invisible, filled with people who think the work they’re doing in Twelve Step rooms is enough. If they can honestly make that call knowing what needs to be done, if someone really has nothing more to give and they’re making their commitments and working with other addicts, then that’s fine. But learn what’s out there and what we could be doing for the benefit off all addicts before you make that call. Don’t make that decision in ignorance.”